The New Politics of Health Care

Published: September 30, 1999

Bill Bradley has proposed a bold and expansive plan to make health insurance available to all Americans. Its details and sizable cost -- roughly $65 billion a year to be financed by the non-Social Security surplus -- will certainly provoke debate from all quarters, and that is a splendid development for the 45 million Americans who lack health insurance. Mr. Bradley and Vice President Al Gore, who proposed a more modest health plan earlier this month, have now made access to health care a central issue of their fight for the Democratic nomination. By elevating the issue in their party, these two Democrats make it harder for the Republican Presidential candidates to avoid engaging the issue.

Mr. Bradley says his voluntary plan would be able to cover 95 percent of all uninsured people, making it the most ambitious program since President Clinton's 1993 health initiative. But at least in outline, the Bradley plan is politically smarter. It would not set up a new bureaucracy to manage the medical marketplace, and it would let consumers rely on existing private or Government insurance plans. The chairman of the Republican National Committee, Jim Nicholson, said the Bradley plan would lead to ''higher taxes,'' and the burden is on Mr. Bradley to show that his subsidies for insuring the poor are fiscally manageable.

Many details have yet to be worked out. It is unclear, for example, whether the proposed amount of premium subsidies for the uninsured would be sufficient to provide adequate health benefit packages or how medical costs would be contained. But in its architecture, the Bradley plan would reach many more people than the plan offered by Mr. Gore, and the impact on the contest between them was instantaneous. After months of ignoring Mr. Bradley, the Vice President yesterday called for a series of debates. We suggest that they make health care the subject of their first meeting. The challenge to Mr. Gore would be to go beyond his worthy, but narrow proposal to cover low-income children. The challenge to Mr. Bradley would be to defend both the cost and practicality of his approach. The challenge for the Republicans, of course, is to get into the discussion that with Mr. Bradley's embracing proposal bids once again to be a dominating issue in another national election.